Psychiatry Explored: Recent Episodes

Psychiatry Education

An educational podcast created to share practice changing principals in psychiatry, behavioral health, and primary care.

Questions? Email: psychiatryexplored@gmail.com Contact: Nakai Corral

Student contributors: Devon Holler, Avery Ballato, Tom Bartlett, Corey Gallet, Lenora Waconda, and Vikas Mankala.

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Tag along as psychiatrists Dr. Julie Anderson and Dr. Sean Stanley unravel the complexities of Major Depressive Disorder (MDD). In this first of two podcasts on mood disorders, they explain MDD's neurological basis, diagnosis, suicide risk assessment, and treatments ranging from medications to psychotherapy to lifestyle changes. A thoughtful discussion of MDD's multifaceted impacts ideal for medical learners, physicians, and interested minds alike.

References:

Patient Health Questionnaire (PHQ-9 & PHQ-2)

Collaborative Care Model

Columbia-Suicide Severity Rating Scale (C-SSRS)

My Resilience in Adolescence (MYRIAD) Project

Barbui, C., Cipriani, A., & Geddes, J. R. (2008). Antidepressants and suicide symptoms: compelling new insights from the FDA’s analysis of individual patient level data. BMJ Ment Health, 11(2), 34-35.

Fournier, J. C., DeRubeis, R. J., Hollon, S. D., Dimidjian, S., Amsterdam, J. D., Shelton, R. C., & Fawcett, J. (2010). Antidepressant drug effects and depression severity: a patient-level meta-analysis. Jama, 303(1), 47-53.

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Join Psychiatrists, Dr. Brandon Cornejo & Dr. Justin Laporte, for a stimulating talk about all things Transcranial Magnetic Stimulation (TMS).

Hosts: Candace Chan, MS4 & Devon Boorstein-Holler, MS4

Have Questions? Feel free to reach out to us at: psychiatryexplored@gmail.com

References:

rTMS for Craving in Methamphetamine Use Disorder, a clinical trial

Carmi, L., Tendler, A., Bystritsky, A., Hollander, E., Blumberger, D. M., Daskalakis, J., ... & Zohar, J. (2019). Efficacy and safety of deep transcranial magnetic stimulation for obsessive-compulsive disorder: a prospective multicenter randomized double-blind placebo-controlled trial. American Journal of Psychiatry, 176(11), 931-938.

Roth, Y., Tendler, A., Arikan, M. K., Vidrine, R., Kent, D., Muir, O., ... & Zangen, A. (2021). Real-world efficacy of deep TMS for obsessive-compulsive disorder: post-marketing data collected from twenty-two clinical sites. Journal of psychiatric research, 137, 667-672.

Voigt, J. D., Leuchter, A. F., & Carpenter, L. L. (2021). Theta burst stimulation for the acute treatment of major depressive disorder: A systematic review and meta-analysis. Translational psychiatry, _11_(1), 330.

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Join Neuropsychiatrist Dr. Jordan Anderson and Psychiatrist Dr. Joel Mack in an expansive discussion on the fascinating world of Functional Neurological Disorders.

Questions? psychiatryexplored@gmail.com

References:

⁠https://neurosymptoms.org⁠ (Signs and symptoms of FND's including functional tremor & examples of entrainment)

Baslet, G., Seshadri, A., Bermeo-Ovalle, A., Willment, K., & Myers, L. (2016). Psychogenic non-epileptic seizures: an updated primer.⁠ _Psychosomatics_, _57_(1), 1-17

LaFrance WC Jr, Miller IW, Ryan CE, Blum AS, Solomon DA, Kelley JE, Keitner GI. Cognitive behavioral therapy for psychogenic nonepileptic seizures.⁠ Epilepsy Behav. 2009 Apr;14(4):591-6. doi: 10.1016/j.yebeh.2009.02.016. Epub 2009 Feb 20. PMID: 19233313.

Perez DL, Edwards MJ, Nielsen G, Kozlowska K, Hallett M, LaFrance WC Jr. Decade of progress in motor functional neurological disorder: continuing the momentum. J Neurol Neurosurg Psychiatry. 2021 Mar 15:jnnp-2020-323953. doi: 10.1136/jnnp-2020-323953

The Dancing Plague of 1518⁠

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Dive into an enlightening conversation with Dr. David Do & Dr. James Koved as they shed light on the specialized realm of psychiatric emergency rooms, the challenges faced in modern mental health care, and the evolving landscape of emergency psychiatry.

Hosted by Candace Chan & Devon Boorstein-Holler

Questions? Reach out to us at: psychiatryexplored@gmail.com

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Join Psychiatrists Dr. Anne Fang, Dr. Veronica Rita Hocker, and Anaesthesiologist Dr. Natalia Guzman-Seda as they explore the electrifying clinical landscape of Electroconvulsive Therapy.

Hosted by Candace Chan & Kathleen Daily-Jensen

Questions? psychiatryexplored@gmail.com

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Sleep Psychiatrist Dr. John Emens takes on the topic of cognitive behavioral therapy for insomnia.

Hosted by Allison Zhou and Nakai Corral

Questions? psychiatryexplored@gmail.com

Topics covered:

  1. Introduction to cognitive behavioral therapy for insomnia
  2. Sleep education
  3. Stimulus control
  4. Sleep restriction therapy
  5. Circumstances in which medication may be indicated
  6. Contraindications to sleep restriction
  7. Alternatives

Studies Mentioned:

Review of CBTI vs. medications: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481424/

Overview of the pharmacology of sleep: https://aasm.org/resources/pdf/pharmacologictreatmentofinsomnia.pdf

Study on two groups with insomnia or not, odds to develop depression: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108260/

Resource for online CBTi: https://www.sleepfoundation.org/insomnia/treatment/cognitive-behavioral-therapy-insomnia

CBTI for depression: https://academic.oup.com/sleep/article/31/4/489/2454177?login=true

IRT vs. IRT + CBT vs. Prazosin: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265653/

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Third-year OHSU medical students, Candace Chan and Devon Boorstein-Holler rehash the information from our first sleep medicine & psychiatry talk in a question-and-answer format. This episode is part of a project to help determine optimal podcast formats for student learning. 

Hosted by: Devon Boorstein-Holler, MS3 & Candace Chan, MS3 

Questions? psychiatryexplored@gmail.com

Studies Mentioned:

Overview on the pharmacology of sleep: https://aasm.org/resources/pdf/pharmacologictreatmentofinsomnia.pdf

Study on melatonin in OTC: https://jcsm.aasm.org/doi/full/10.5664/jcsm.6434

NEJM Bob Sack review melatonin for jet lag: https://www.nejm.org/doi/10.1056/NEJMcp0909838?url_ver=Z39.88-%202003&rft_id=ori:rid:crossref.org&rfr_dat-cr_pub%20%200pubmed

Study on two groups with insomnia or not, odds to develop depression: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108260/

Resource for online CBTI: https://www.sleepfoundation.org/insomnia/treatment/cognitive-behavioral-therapy-insomnia

CBTI for depression: https://academic.oup.com/sleep/article/31/4/489/2454177?login=true

IRT vs. IRT+CBT vs. Prazosin: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265653/

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Surgeon Dr. Andrea Stroud and psychologist Dr. Thomas Kern take on the topic of Bariatric Surgery.

Hosted by Sheuli Chowdhury and Nakai Corral

Questions? psychiatryexplored@gmail.com

Topics covered:

  1. Indications for bariatric surgery
  2. Psychological implications: pre and post

Studies Mentioned:

Some recent obesity statistics: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493650/

Obesity and diabetes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3066828/

Depression and suicide after bariatric surgery: https://pubmed.ncbi.nlm.nih.gov/31410656/

Long-term depression/anxiety review: https://pubmed.ncbi.nlm.nih.gov/30795495/

Disordered eating and impulsivity: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6538470/

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Host: Avery Ballato

Part 1: The presentation and evolution of methamphetamine use in the clinical setting with Dr. Jordan Laub, MD MPH FACEP

Part 2: The management and impact of methamphetamine use in and out of the clinical setting with Curtis Johnson, LCSW

Sources: https://www.samhsa.gov/data/data-we-collect/dawn-drug-abuse-warning-network

This episode is not affiliated with OHSU.

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Psychologist Dr. Joel Nigg takes on the topic of ADHD.

Hosted by Nakai Corral

Questions? psychiatryexplored@gmail.com

Topics covered:

  1. How to speak to patients/parents about the diagnosis
  2. Emotional dysregulation
  3. Genetic basis of ADHD
  4. Nutritional treatments
  5. Impact of stimulants
  6. Trends in diagnosis and treatment
  7. Media, the internet, and our kids' attention

Studies Mentioned:

Study on stimulants and impact on grades: https://pubmed.ncbi.nlm.nih.gov/35604744/

Study on stimulants and addiction: https://www.sciencedirect.com/science/article/abs/pii/S0306460313002608?casa_token=jwUw58PypHoAAAAA:W0SbeZ6OmxvAM5WJmSnxtsW5_WBh0ZFjq-vrin_cR9wUWdJjeYpQKSqDq7SEBFvHCprbA1KOtxI

Reduction in height with stimulants: https://www.sciencedirect.com/science/article/abs/pii/S0890856708600763?casa_token=eg8stVhUO28AAAAA:65KbhBjbeOuh0pjiaGout3k8NRI1wURGXMSUtWVKTIc_XiLbXk0TTDs-unQ4jqpqaDZdVlOdUPg

Brain growth and stimulants: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4183380/, https://pubmed.ncbi.nlm.nih.gov/23247506/

Correction from Dr. Nigg: There’s actually not a clear conclusive finding here that I can see after more studies have come out. Only correlational studies. The main MRI finding on structure is no evidence of harm. When we do see structural changes over time (e.g., one randomized controlled trial) it’s unclear what it means.

Animal model of stimulant use and neuronal damage: https://pubmed.ncbi.nlm.nih.gov/27575717/

Omega 3 supplements and ADHD symptoms: https://www.tandfonline.com/doi/full/10.1080/09540260600583031?casa_token=IvSUmSWkf6gAAAAA:u8lp26TFqEsj5KIQQdTKw4vpcqXXodm612ikG9sSg742FbSeYYl3TK4frxgoDwDPXdBiUbNMJTjpXw

Vitamin D supplementation and ADHD symptoms: https://www.tandfonline.com/doi/full/10.1080/1028415X.2016.1262097?casa_token=WHfv4XoZMZYAAAAA:Wwcjgg8dpNsp1k9Je1oMVI9W7GRhhgWuVZT2WuqaKrgyUq7uVsZwPAuLUQnTa-gb0LgzsJlbxn8PfA

Multi-nutrient supplements and ADHD symptoms: https://pubmed.ncbi.nlm.nih.gov/34303786/

Mindfulness w/ parents and kids with ADHD: https://pubmed.ncbi.nlm.nih.gov/35847187/

MTA trials: https://journals.lww.com/jrnldbp/Abstract/2001/02000/Findings_from_the_NIMH_Multimodal_Treatment_Study.8.aspx

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Sleep psychiatrist Dr. Emens and sleep specialist Dr. Mukundan take on the topic sleep medicine through a psychiatric lens.

Hosted by Tom Bartlett and Nakai Corral

Questions? psychiatryexplored@gmail.com

Topics covered:

  1. Importance of sleep
  2. Cognitive behavioral therapy for insomnia
  3. Melatonin
  4. Substance use and ADHD
  5. Benzodiazepines and BZRAs
  6. PTSD

Studies Mentioned:

Overview on pharmacology of sleep: https://aasm.org/resources/pdf/pharmacologictreatmentofinsomnia.pdf

Study on melatonin in OTC: https://jcsm.aasm.org/doi/full/10.5664/jcsm.6434

NEJM Bob Sack review melatonin for jet lag: https://www.nejm.org/doi/10.1056/NEJMcp0909838?url_ver=Z39.88-2003𝔯_id=ori:rid:crossref.org𝔯_dat=cr_pub%20%200pubmed

Dr. Sack's study on blind individuals and melatonin: https://grantome.com/grant/NIH/R01-MH056874-01

Study on two groups with insomnia or not, odds to develop depression: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108260/

Resource for online CBTi: https://www.sleepfoundation.org/insomnia/treatment/cognitive-behavioral-therapy-insomnia

CBTI for depression: https://academic.oup.com/sleep/article/31/4/489/2454177?login=true

Cannabis and sleep: https://pubmed.ncbi.nlm.nih.gov/31895189/

IRT vs. IRT + CBT vs. Prazosin: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265653/

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Psychiatrists Dr. Roff and Dr. D'Souza take on the topic of diagnosis and treatment of borderline personality disorder. 

Hosted by Dr. Vikas Mankala and Nakai Corral

Questions? psychiatryexplored@gmail.com

Borderline personality disorder is a complex mental health condition that is characterized by difficulty managing emotions and behavior, impulsiveness, instability of interpersonal relationships, and insecurity - which often presents as self-image issues. Most diagnoses are made during early adulthood, and the core features cause significant impairment in every day life. It is estimated that the lifetime prevalence of borderline personality disorder is 6 percent, with studies showing that the diagnosis was present in 6.4 percent of urban primary care patient, 9.3 percent of psychiatric outpatients, and a staggering 20 percent of psychiatric inpatients. The ratio of females to males is approximately 3:1 in clinical settings, however the lifetime prevalence does not differ significantly between men and women. Co-occuring psychiatric disorders are common including mood, anxiety, substance-use, eating and somatoform disorders.

Borderliner notes: https://www.youtube.com/c/BorderlinerNotes

What is Dialectical behavior therapy for adolescents (DBT)?: https://youtu.be/Stz--d17ID4

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Addiction specialists Dr. Thomas Meeks and Dr. Honora Englander take on the topic of opioid use disorder. 

Hosted by Lenora Waconda and Nakai Corral

Questions? psychiatryexplored@gmail.com

Fentanyl Concentrations in Canada: https://drugcheckingbc.ca/wp-content/uploads/sites/2/2022/04/Drug_Checking_BC_Mar_2022.pdf

Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2760032

Opioid Agonist Discontinuation: https://pubmed.ncbi.nlm.nih.gov/35489179/ 

Microinduction of Buprenorphine/Naloxone: A Review of the Literature: https://pubmed.ncbi.nlm.nih.gov/33378137/

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Psychiatrists Dr. Asha Jetmalani and Dr. Craigan Usher take on the topics of gender dysphoria, transgender psychiatric care, and pediatric management. 

Hosted by Corey Gallet de Saint-Aurin and Nakai Corral

Questions? psychiatryexplored@gmail.com

Let’s Talk Gender: Ten Things Transgender and Nonbinary Youth Want All Researchers to Know - https://www.jaacap.org/article/S0890-8567(21)02095-5/fulltext

Ten Things Transgender and Gender Nonconforming Youth Want Their Doctors to Know - https://www.jaacap.org/article/S0890-8567(17)30027-8/fulltext

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Psychiatrists Dr. Sean Stanley and Dr. Mikaela Rodriguez take on adult ADHD treatment and diagnosis. 

Hosted by Nakai Corral and Devon Holler